TUMOURS AND CYSTS OF NOSE AND SINUS

Tumours and Cysts of Nose and Sinus

Benign Tumours of Nose and Sinus

1. Fibroma

   • Definition: A benign tumour composed of fibrous tissue.
   • Types:
     • Fibromatosis (aggressive fibromatosis)
     • Fibroma (solitary fibroma)
     • Juvenile nasopharyngeal angiofibroma
   • Causes: Unknown
   • Clinical Features:
     • Common in children and young adults
     • Presents as a painless, non-bleeding mass in the nasal cavity or nasopharynx
     • Can cause nasal obstruction, epistaxis, or facial pain
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision is the treatment of choice
   • Treatment: Complete surgical removal of the tumour

2. Hemangioma

   • Definition: A benign tumour composed of blood vessels.
   • Types:
     • Cavernous hemangioma
     • Cystic hemangioma
     • Capillary hemangioma
   • Causes: Unknown
   • Clinical Features:
     • Common in infants and children
     • Presents as a blue or purple mass in the nasal cavity or nasopharynx
     • Can cause nasal obstruction, epistaxis, or facial pain
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision or embolization is the treatment of choice
   • Treatment: Complete surgical removal of the tumour or embolization of the blood vessels

3. Lipoma

   • Definition: A benign tumour composed of fat tissue.
   • Causes: Unknown
   • Clinical Features:
     • Common in adults
     • Presents as a painless, non-bleeding mass in the nasal cavity or nasopharynx
     • Can cause nasal obstruction or facial pain
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision is the treatment of choice
   • Treatment: Complete surgical removal of the tumour

4. Osteoma

   • Definition: A benign tumour composed of bone tissue.
   • Causes: Unknown
   • Clinical Features:
     • Common in adults
     • Presents as a painless, non-bleeding mass in the nasal cavity or sinuses
     • Can cause nasal obstruction, facial pain, or sinusitis
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision is the treatment of choice
   • Treatment: Complete surgical removal of the tumour

Cysts of Nose and Sinus

1. Mucous Cyst

   • Definition: A benign cyst lined by mucous membrane.
   • Causes: Trauma to the nasal cavity or sinuses
   • Clinical Features:
     • Presents as a painless, non-bleeding mass in the nasal cavity or sinuses
     • Can cause nasal obstruction or facial pain
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical drainage or excision is the treatment of choice
   • Treatment: Drainage of the cyst or complete surgical removal

2. Odontogenic Cyst

   • Definition: A benign cyst associated with teeth.
   • Causes: Abnormal development of teeth
   • Clinical Features:
     • Presents as a painless, non-bleeding mass in the nasal cavity or sinuses
     • Can cause nasal obstruction, facial pain, or toothache
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision is the treatment of choice
   • Treatment: Complete surgical removal of the cyst

3. Nasolacrimal Duct Cyst

   • Definition: A benign cyst associated with the nasolacrimal duct.
   • Causes: Abnormal development of the nasolacrimal duct
   • Clinical Features:
     • Presents as a painless, non-bleeding mass in the nasal cavity
     • Can cause nasal obstruction or epiphora
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision is the treatment of choice
   • Treatment: Complete surgical removal of the cyst

Malignant Tumours of Nose and Sinus

1. Squamous Cell Carcinoma

   • Definition: A malignant tumour composed of squamous epithelial cells.
   • Causes: Unknown
   • Clinical Features:
     • Presents as a painless, non-bleeding mass in the nasal cavity or sinuses
     • Can cause nasal obstruction, facial pain, or sinusitis
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision, radiation therapy, or chemotherapy is the treatment of choice
   • Treatment: Complete surgical removal of the tumour, radiation therapy, or chemotherapy

2. Adenocarcinoma

   • Definition: A malignant tumour composed of glandular epithelial cells.
   • Causes: Unknown
   • Clinical Features:
     • Presents as a painless, non-bleeding mass in the nasal cavity or sinuses
     • Can cause nasal obstruction, facial pain, or sinusitis
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision, radiation therapy, or chemotherapy is the treatment of choice
   • Treatment: Complete surgical removal of the tumour, radiation therapy, or chemotherapy

3. Melanoma

   • Definition: A malignant tumour composed of melanocytes.
   • Causes: Unknown
   • Clinical Features:
     • Presents as a painless, non-bleeding mass in the nasal cavity or sinuses
     • Can cause nasal obstruction, facial pain, or skin pigmentation
   • Investigations: Diagnosis is based on clinical examination and imaging studies (MRI, CT scan)
   • Management: Surgical excision, radiation therapy, or chemotherapy is the treatment of choice
   • Treatment: Complete surgical removal of the tumour, radiation therapy, or chemotherapy

Blood Supply and Nerve Supply of Nose and Sinus

1. Blood Supply:

   • The nasal cavity and sinuses are supplied by the following arteries:
     • Anterior ethmoidal artery
     • Posterior ethmoidal artery
     • Sphenopalatine artery
     • Superior labial artery
   • The blood supply is rich and dense, making it a challenging area for surgical intervention

2. Nerve Supply:

   • The nasal cavity and sinuses are innervated by the following nerves:
     • Olfactory nerve
     • Nasociliary nerve
     • Infraorbital nerve
     • Greater palatine nerve
   • The nerve supply is complex and can be involved in various surgical procedures

Clinical Anatomy of Nose and Sinus

1. Nasal Cavity:

   • The nasal cavity is a complex structure composed of:
     • Turbinate bones
     • Nasal conchae
     • Nasal septum
     • Nasal meatus
   • The nasal cavity is lined by mucous membrane and is involved in various respiratory and olfactory functions

2. Sinuses:

   • The sinuses are a group of air-filled cavities located within the bones of the skull:
     • Frontal sinus
     • Maxillary sinus
     • Ethmoid sinus
     • Sphenoid sinus
   • The sinuses are lined by mucous membrane and are involved in various respiratory and auditory functions

Homoeopathic Therapeutic Medicines

1. Calcarea Carbonica:

   • Indications: Nasal polyps, nasal obstruction, and facial pain
   • Dosage: 6c, 3 times a day

2. Kali Bichromicum:

   • Indications: Nasal discharge, nasal congestion, and facial pain
   • Dosage: 6c, 3 times a day

3. Nux Vomica:

   • Indications: Nasal congestion, facial pain, and sinusitis
   • Dosage: 6c, 3 times a day

4. Pulsatilla:

   • Indications: Nasal discharge, nasal congestion, and facial pain
   • Dosage: 6c, 3 times a day

5. Silica:

   • Indications: Nasal polyps, nasal obstruction, and facial pain
   • Dosage: 6c, 3 times a day